Better Health Care Outcomes in Unprecedented Times: A Review of Conceptual Frameworks to Aid Understanding and Decision-Making

Abstract

This article presents readers an overview of three recently articulated conceptual frameworks for (1) intelligence, (2), moral development in ethical decision-making, and (3) practical wisdom with the aim of giving useful guidance for understanding and improving health care decision-making. The first framework conception is the notion of “learnable intelligence,” how we acquire “mindware,” ways of thinking that are analogous to software subroutines on a computer. Sometimes, however, important mindware is missing or malfunctioning, and this prevents wise decision-making and requires that the relevant mindware be repaired or installed. The second framework concerns the development of moral rules and how the moral rules have the aim of reducing the harms we experience. A process for justifying the moral rules is provided, and this framework also includes permitting violations of those moral rules in exceptional circumstances by giving a decision guide for how to justify those violations. There is evidence presented that this framework comports with the psychology of moral development. The third framework examines a conceptualization of practical wisdom and presents examples of how it can be related to health care decision-making. Finally, we survey the global problem of widespread misinformation about science in general and health care in particular, such as misconceptions of vaccine safety and efficacy. We outline current efforts made to understand this phenomenon and to deal with the problems misinformation causes, in part by improving the mindware of decision makers. Finally, we discuss suggestions for further research and practice.